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' <br /> #1141111:1Pe BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 2`A one.'-e..W <br /> BWV inspected by: �,.,. JiivY1 lia(ice Date BWV was Inspected: : <br /> u/3 W►) e ! 5e e art) <br /> Inspection Checklist e f F hips,Apie, vil p-eirovis e. <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? ❑ Yes ❑ No <br /> Comments: <br /> Does BWV positioning meets minimum slope requirement of>1%? ❑ Yes ❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? ❑ Yes ❑ No <br /> Can BWV be secured into the proper position? ❑ Yes ❑ No <br /> Where is the valve installed (general description, attach map)? <br /> Is the installed BWV considered an 'approved' model by the City of Everett? ❑ Yes n No <br /> Was property owner shown how to inspect and maintain their BWV? ❑ Yes ❑ No <br /> Does this BWV require repair or replacement? ❑ Yes ❑ No <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2014 <br />